|
Golimumab 12.5 mg/ml intravenous solution
|
$2,667.61 |
$2,667.61 |
$2,667.61 |
$5,009.45
|
|
Gonadotropin follicle stimulating hormone (fsh)
|
$104.15 |
$104.15 |
$104.15 |
$110.04
|
|
Gonadotropin luteinizing hormone (lh)
|
$104.15 |
$104.15 |
$104.15 |
$123.75
|
|
Goserelin 10.8 mg subcutaneous implant
|
$1,993.15 |
$1,993.15 |
$1,993.15 |
$2,802.00
|
|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$2,202.93 |
$2,202.93 |
$2,202.93 |
$2,648.81
|
|
Graft axiofill 1000mg
|
$3,311.83 |
$3,311.83 |
$3,311.83 |
$5,278.73
|
|
Graft impl ult thck 6x12cm -cost per sq cm
|
$2,285.25 |
$2,285.25 |
$2,285.25 |
$25,762.70
|
|
Graft nerve adv 3-4x70mm
|
$8,232.45 |
$8,232.45 |
$8,232.45 |
$27,495.00
|
|
Graft patch felt ptfe 2x2
|
$15,143.73 |
$15,143.73 |
$15,143.73 |
$25,728.84
|
|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$11,176.79 |
$11,176.79 |
$11,176.79 |
$1,560.21
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$1,732.29 |
$1,732.29 |
$1,732.29 |
$2,369.10
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$1,099.48 |
$1,099.48 |
$1,099.48 |
$336.78
|
|
Graft xenmtrx sft rect 15x20cm
|
$14,246.59 |
$14,246.59 |
$14,246.59 |
$43,312.93
|
|
Graft xenmtrx sft rect 19x28cm
|
$115.56 |
$115.56 |
$115.56 |
$2,653.10
|
|
Granisetron hcl injection
|
$10.42 |
$10.42 |
$10.42 |
$41.65
|
|
Group mnt 2 or more 30 mins
|
$45.63 |
$45.63 |
$45.63 |
$35.20
|
|
Growth stimulation gene 2
|
$180.03 |
$180.03 |
$180.03 |
$223.47
|
|
G-tube reposition
|
$165.65 |
$165.65 |
$165.65 |
$741.00
|
|
Gu dilat ureter/urethra s&i
|
$1,183.29 |
$1,183.29 |
$1,183.29 |
$1,793.00
|
|
Guided cath fluid drainage 10030
|
$1,103.95 |
$1,103.95 |
$1,103.95 |
$1,461.15
|
|
Guide wire threaded 1.4x150mm
|
$718.61 |
$718.61 |
$718.61 |
$3,474.86
|
|
Guide worley csg 9fx50cm std
|
$993.85 |
$993.85 |
$993.85 |
$2,229.99
|
|
Guid loc target vol rad tx
|
$840.61 |
$840.61 |
$840.61 |
$503.80
|
|
Gw stiffened micro access kit
|
$3,788.91 |
$3,788.91 |
$3,788.91 |
$6,285.56
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$60.01 |
$60.01 |
$60.01 |
$112.36
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$13.40 |
$13.40 |
$13.40 |
$35.40
|
|
Haptoglobin quantitative
|
$69.93 |
$69.93 |
$69.93 |
$89.95
|
|
Hba1/hba2 gene dup/del vrnts
|
$325.34 |
$325.34 |
$325.34 |
$406.25
|
|
Hbb full gene sequence
|
$660.58 |
$660.58 |
$660.58 |
$633.25
|
|
Hbb gene dup/del variants
|
$116.55 |
$116.55 |
$116.55 |
$404.80
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$1,668.81 |
$1,668.81 |
$1,668.81 |
$759.72
|
|
Hcg free betachain test
|
$116.05 |
$116.05 |
$116.05 |
$54.59
|
|
Hcg qualitative
|
$58.03 |
$58.03 |
$58.03 |
$77.50
|
|
Hcg quantitative
|
$96.22 |
$96.22 |
$96.22 |
$124.80
|
|
Hc hearing aid chck binaurl
|
$34.72 |
$34.72 |
$34.72 |
$78.40
|
|
Hc hearing aid chck monarl
|
$54.06 |
$54.06 |
$54.06 |
$48.00
|
|
Hc hearing aid exam both ears
|
$78.86 |
$78.86 |
$78.86 |
$175.20
|
|
Hc hearing aid exam one ear
|
$103.16 |
$103.16 |
$103.16 |
$157.50
|
|
Hc i-131 sodium iodide cap dx per mci
|
$136.88 |
$136.88 |
$136.88 |
$136.50
|
|
Hc nm kidney imaging with flow
|
$1,357.37 |
$1,357.37 |
$1,357.37 |
$1,008.39
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$945.74 |
$945.74 |
$945.74 |
$1,186.80
|
|
Hc pet myocardial imaging metabolic eval single study
|
$2,074.48 |
$2,074.48 |
$2,074.48 |
$3,309.00
|
|
Head CT scan (with and without contrast)
|
$1,312.73 |
$1,312.73 |
$1,312.73 |
$1,878.75
|
|
Head CT scan (with contrast)
|
$1,114.86 |
$1,114.86 |
$1,114.86 |
$1,520.45
|
|
Head CT scan (without contrast)
|
$790.52 |
$790.52 |
$790.52 |
$1,268.90
|
|
Heart first pass add-on
|
$468.66 |
$468.66 |
$468.66 |
$445.54
|
|
Heart infarct image
|
$607.02 |
$607.02 |
$607.02 |
$840.74
|
|
Helicobacter pylori antibody igm
|
$153.74 |
$153.74 |
$153.74 |
$84.80
|
|
Hemagglutination inhibition
|
$114.56 |
$114.56 |
$114.56 |
$17.60
|
|
Hematocrit
|
$28.27 |
$28.27 |
$28.27 |
$33.57
|
|
Hemoglobin
|
$28.27 |
$28.27 |
$28.27 |
$31.75
|
|
Hemoglobin fetal qualitative
|
$37.20 |
$37.20 |
$37.20 |
$51.75
|
|
Hemoglobin methemoglobin quantitative
|
$141.35 |
$141.35 |
$141.35 |
$49.40
|
|
Hemoglobin plasma
|
$115.56 |
$115.56 |
$115.56 |
$40.56
|
|
Hemolysins/agglutinins auto
|
$60.01 |
$60.01 |
$60.01 |
$53.90
|
|
Hemolysins and agglutinins incubated
|
$97.21 |
$97.21 |
$97.21 |
$67.50
|
|
Hemophilus influenza antibdy
|
$51.09 |
$51.09 |
$51.09 |
$56.80
|
|
Hepagam b im injection
|
$205.32 |
$205.32 |
$205.32 |
$464.00
|
|
Heparin assay
|
$157.71 |
$157.71 |
$157.71 |
$130.20
|
|
Heparin bolus from bag
|
$14.37 |
$14.37 |
$14.37 |
$79.04
|
|
Heparin neutralization
|
$29.76 |
$29.76 |
$29.76 |
$47.45
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$22.11 |
$22.11 |
$22.11 |
$32.27
|
|
Hepatitis a antibody igm
|
$101.67 |
$101.67 |
$101.67 |
$85.15
|
|
Hepatitis b core antibody igm
|
$100.18 |
$100.18 |
$100.18 |
$87.98
|
|
Hepatitis b core antibody total
|
$103.65 |
$103.65 |
$103.65 |
$83.29
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$204.33 |
$204.33 |
$204.33 |
$1,116.61
|
|
Hepatitis b surface antibody
|
$102.17 |
$102.17 |
$102.17 |
$83.79
|
|
Hepatitis c antibody
|
$102.17 |
$102.17 |
$102.17 |
$108.00
|
|
Hepatobiliary system imaging
|
$784.07 |
$784.07 |
$784.07 |
$1,521.10
|
|
Hereditary colon ca dsordrs
|
$1,017.16 |
$1,017.16 |
$1,017.16 |
$1,956.00
|
|
Herpes simplex type 1 antibody igg
|
$67.95 |
$67.95 |
$67.95 |
$70.00
|
|
Herpes simplex type 2 antibody igg
|
$59.52 |
$59.52 |
$59.52 |
$87.10
|
|
Heterophile antibodies screening
|
$47.12 |
$47.12 |
$47.12 |
$73.60
|
|
Heterophile antibodies titer
|
$405.18 |
$405.18 |
$405.18 |
$16.80
|
|
Hexa gene
|
$560.90 |
$560.90 |
$560.90 |
$179.04
|
|
Hhv-6 dna quant
|
$256.90 |
$256.90 |
$256.90 |
$200.25
|
|
Histamine
|
$316.41 |
$316.41 |
$316.41 |
$125.40
|
|
Histochemical stains add-on
|
$152.26 |
$152.26 |
$152.26 |
$169.65
|
|
Hiv-1 ag ia
|
$323.85 |
$323.85 |
$323.85 |
$84.67
|
|
Hla class i high defin qual
|
$329.80 |
$329.80 |
$329.80 |
$574.86
|
|
Hla class i&ii antibody qual
|
$326.82 |
$326.82 |
$326.82 |
$207.60
|
|
Hla class i/ii antibody qual
|
$190.94 |
$190.94 |
$190.94 |
$88.58
|
|
Hla ii typing 1 loc hr
|
$470.64 |
$470.64 |
$470.64 |
$323.40
|
|
Hla i low res one antigen equiv ea
|
$250.95 |
$250.95 |
$250.95 |
$164.00
|
|
Hla i typing 1 locus hr
|
$440.39 |
$440.39 |
$440.39 |
$398.40
|
|
Hla i typing high res 1 allele grp ea
|
$245.49 |
$245.49 |
$245.49 |
$307.53
|
|
Hla i typing low res one locus ea
|
$177.05 |
$177.05 |
$177.05 |
$340.00
|
|
Hla typing a b or c
|
$1,079.15 |
$1,079.15 |
$1,079.15 |
$309.40
|
|
Hocm 350-399mg/ml iodine,1ml
|
$16.87 |
$16.87 |
$16.87 |
$68.86
|
|
Homocysteine
|
$107.62 |
$107.62 |
$107.62 |
$113.10
|
|
Homovanillic acid (hva)
|
$164.16 |
$164.16 |
$164.16 |
$56.00
|
|
Hpv types 16 & 18 only
|
$293.10 |
$293.10 |
$293.10 |
$93.60
|
|
H pylori (c-13) breath
|
$225.65 |
$225.65 |
$225.65 |
$219.05
|
|
H pylori drug admin
|
$46.13 |
$46.13 |
$46.13 |
$31.99
|
|
Htt gene detc abnor alleles
|
$369.47 |
$369.47 |
$369.47 |
$252.45
|
|
Human epididymis protein 4 (he4)
|
$284.67 |
$284.67 |
$284.67 |
$131.84
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$78.36 |
$78.36 |
$78.36 |
$198.97
|
|
Hydralazine 20 mg/ml injection solution
|
$14.88 |
$14.88 |
$14.88 |
$57.02
|
|
Hydration IV infusion each additional hour
|
$33.73 |
$33.73 |
$33.73 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$121.01 |
$121.01 |
$121.01 |
$394.40
|